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Effect of the Learning Curve on Visual and Refractive Outcomes of Small-Incision Lenticule Extraction. | LitMetric

Effect of the Learning Curve on Visual and Refractive Outcomes of Small-Incision Lenticule Extraction.

Cornea

*Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; †Department of Ophthalmology, The University of Hong Kong, Hong Kong, China; ‡Hong Kong Laser Eye Center, Hong Kong, China; §Tianjin Eye Hospital and Eye Institute, Tianjin, China; and ¶University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA.

Published: September 2017

AI Article Synopsis

  • The study aimed to evaluate how the learning curve affects the outcomes of small-incision lenticule extraction over the first two years of a surgeon's practice.
  • Two patient groups were compared: the first 100 patients treated versus the most recent 100 patients, using the same laser and technique.
  • Results indicated that with increased experience, the surgeon achieved better post-surgery visual outcomes, a higher safety index, and improved accuracy in correcting astigmatism.

Article Abstract

Purpose: To investigate the effect of the learning curve for small-incision lenticule extraction during the first 2 years of experience.

Methods: Small-incision lenticule extraction was performed using the 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec) by the same surgeon. The initial 100 patients since the surgeon started operating independently were considered as group 1; the recent 100 patients were considered as group 2. The same laser settings and technique were used. The visual and refractive outcomes were compared between groups at postoperative 1 week and 6 months. Vector analysis was performed for eyes with astigmatic correction.

Results: Two hundred right eyes of 200 patients were included. Age, preoperative corrected visual acuity, manifest refraction, and central corneal thickness were similar between groups (P ≤ 0.154). Postoperatively, the efficacy index at 1 week was better in group 2 (group 1: 0.85 ± 0.16 vs. group 2: 0.91 ± 0.10, P = 0.019) but was similar between groups at 6 months (group 1: 0.91 ± 0.14 vs. group 2: 0.94 ± 0.08, P = 0.181). The safety index was higher in group 2 at 1 week (group 1: 0.93 ± 0.10 vs. group 2: 0.95 ± 0.08, P = 0.045) and 6 months postoperatively (group 1: 0.97 ± 0.07 vs. group 2: 0.99 ± 0.03, P = 0.011). Vector analysis showed that postoperative residual astigmatism and misalignment of astigmatic correction were lower in group 2 than in group 1 (P ≤ 0.039) at 1 week and 6 months. The duration of docking and that of lenticule extraction was shorter in group 2 (P ≤ 0.034).

Conclusions: Our study showed that faster visual recovery, better safety profile, and more accurate astigmatic correction could be attained with increasing surgical experience.

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Source
http://dx.doi.org/10.1097/ICO.0000000000001246DOI Listing

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